Villar H V, Norton L W
Am J Surg. 1979 Feb;137(2):170-4. doi: 10.1016/0002-9610(79)90138-7.
Seven patients with acute and progressive abdominal distension secondary to massive cecal and right colon ileus are analyzed. Five had pseudoobstruction of the colon and two had cecal volvulus. Two of the patients with pseudoobstruction and one with cecal volvulus died from preexisting diseases. Pseudoobstruction of the colon is not a rare complication of elderly, sick, bedridden patients. Differential diagnoses include cecal and sigmoid volvulus and acute gastric dilation. Initial conservative therapy is warranted if no peritoneal signs are present. If the cecal diameter is more than 12 cm, colonoscopic decompression with a fiberscope should be attempted. If unsuccessful, tube cecostomy will provide curative, life-saving therapy even if taenia splitting is present. Perforation or widely scattered areas of necrosis make resection mandatory.
对7例因巨大盲肠和右半结肠肠梗阻继发急性进行性腹胀的患者进行了分析。其中5例为结肠假性梗阻，2例为盲肠扭转。2例假性梗阻患者和1例盲肠扭转患者死于基础疾病。结肠假性梗阻在老年、患病、卧床患者中并非罕见的并发症。鉴别诊断包括盲肠和乙状结肠扭转以及急性胃扩张。如果没有腹膜刺激征，初始应采取保守治疗。如果盲肠直径超过12 cm，应尝试用纤维结肠镜进行结肠减压。如果不成功，即使存在结肠带分裂，管盲肠造口术也将提供治愈性的、挽救生命的治疗。穿孔或广泛散在的坏死区域则必须进行切除术。
